title: The Mannerfelt wrist arthrodesis - a study of patient-reported outcomes in a rheumatoid population.
abstract: BACKGROUND
  Wrist arthrodesis has been established as a mainstay form of surgical intervention in the rheumatoid wrist. Despite this however, there is a distinct lack of patient-reported outcome measure (PROM) studies justifying the efficacy of this procedure in rheumatoid disease. The aim of this study was to report any change in function or pain following the tunnel Mannerfelt wrist arthrodesis in a single surgeon series of rheumatoid patients over a 6 year period.
  
  
  METHODS
  14 consecutive patients (15 wrists) who had undergone the Mannerfelt wrist arthrodesis were followed prospectively with a mean follow up period of 45 months. No patients were lost to follow up. The primary outcome measures included the validated Patient Rated Wrist Evaluation (PRWE) questionnaire and a satisfaction questionnaire.
  
  
  RESULTS
  The mean total pain score improved from 41 points preoperatively to 14.2 points postoperatively correlating with a 65.4% improvement in overall pain outcomes. The mean total functional score improved from 83.7 points preoperatively to 45.5 points postoperatively demonstrating a 45.6% improvement in overall function at the time of follow up.
  
  
  CONCLUSIONS
  All patients reported an overall improvement in pain and functional capacity. The satisfaction results were excellent. All patients reported that they would elect to have the procedure again with the vast majority being 'very pleased' with the outcome of their surgery (93.7% very pleased and 6.3% fairly pleased). The procedure enjoyed favourable mid-term results and we recommend the tunnel Mannerfelt wrist arthrodesis for improving both pain and level of function in this group of patients.
authors.affiliation: Department of Orthopaedic Surgery, New Royal Infirmary of Edinburgh, Little France, Edinburgh EH16 4SU, UK.
authors.forename: F K
authors.initials: FK
authors.lastname: Elherik
authors.affiliation: Department of Orthopaedic Surgery, New Royal Infirmary of Edinburgh, Little France, Edinburgh EH16 4SU, UK. Electronic address: nb21@doctors.org.uk.
authors.forename: N
authors.initials: N
authors.lastname: Beattie
authors.affiliation: Department of Orthopaedic Surgery, New Royal Infirmary of Edinburgh, Little France, Edinburgh EH16 4SU, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Breusch
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011446:Prospective Studies; D011859:Radiography; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Mannerfelt; PRWE; Patient-reported outcome measures; Wrist arthrodesis; Wrist fusion